Types of Asthma

The term “asthma” comes from the Greek meaning “to breathe hard.” Medical terminology defines the condition as Reversible Obstructive Airways Disease (ROAD).

Asthma can strike anyone at any time and under any circumstances. Until recently, the condition was divided into two clearly defined types: “extrinsic” (allergic) and “intrinsic” (non-allergic). Nowadays, however, a more group-type approach is preferred.

These types include:

  • Childhood: the main cause of chronic illness among school age children today; more prevalent in boys.
  • Adult onset: becoming increasingly commonplace; frequently triggered by allergies; affects women predominantly.
  • Occupational: often difficult to diagnose; results from regular exposure to pollutants, chemicals, allergens and other substances present in the workplace.
  • Exercise-linked: triggered by exercise in those who already have the condition; can induce new cases in all age groups.
  • Pregnancy: symptoms improve approximately 1/3 of the time during pregnancy, 1/3 remain the same and 1/3 worsen; safe medications are available for use during pregnancy.
  • Elderly: number of new cases is on the rise; often accompanied by additional medical problems.
  • Nocturnal: caused by reduced lung function at nighttime; tends to be more severe during early morning hours.
  • Steroid-resistant: inhalation steroid therapy has proven effective for many asthmatics; some sufferers become steroid-resistant.

The term “asthma” comes from the Greek meaning “to breathe hard.” Medical terminology defines the condition as Reversible Obstructive Airways Disease (ROAD).

Unlike other conditions that obstruct the air tubes, such as cystic fibrosis, chronic bronchitis and emphysema, bronchial asthma does not affect sufferers all of the time.

But, be warned! Although attacks can vary considerably in their severity and are sometimes relatively mild, the condition is nevertheless a dangerous one. It can easily spiral out of control at any time. This is particularly true for children.

Asthma Medication FAQs

The following FAQs provide warnings and information about asthma drug interactions.

Q. Is there a connection between the occurrence of childhood measles and the likelihood of developing asthma later in life?

A. Medical opinions differ regarding this issue. One school of thought argues that contracting measles as a child actually decreases the chance of developing childhood or adult-onset asthma. Other experts believe that the occurrence of childhood measles is less important and that risk is more dependent on whether one or both parents are asthmatic.

A study of more than 300 adults in Aberdeen, UK, concluded that early childhood infection with measles had a positive effect later in life. Subjects with measles were less likely than a control group to be diagnosed with asthma in their twenties and thirties.

Q. I’ve heard that many non-prescription drugs contain albuterol. Is this true and if so, what are the risks of taking such medications if I’m already using an albuterol inhaler to control my asthma?

A. Certain non-prescription drugs, such as diet pills or “over-the-counter” medications for the common cold, contain albuterol. Don’t take any of these medicines without first consulting your doctor. This is particularly important if you’re pregnant.

Q. I’m currently taking theophylline for control. I also have an ulcer and was wondering whether it’s safe to take TagametĀ® to treat my ulcer while taking theophylline.

A. Asthmatics should always be wary of taking cimetidine (branded as Tagamet) in combination with theophylline. In certain cases, cimetidine is capable of increasing the level of theophylline in the bloodstream to toxic levels. Cimetidine should also not be taken with certain blood thinners, seizure medications, and heart rhythm drugs.

Hidden Dangers

Children and adults diagnosed with asthma must be particularly wary of taking common drugs (e.g. aspirin, cough medicine and TagametĀ®) in combination with their asthma medication. The treatment of common ailments such as measles, chicken pox and even ordinary respiratory infections can sometimes lead to complications in the asthmatic. Caution is particularly appropriate when interaction between common drugs and prescribed corticosteroids (asthma drugs that simulate natural steroid hormones) might occur.

Check all labels and inserts for warnings. Tell your doctor and pharmacist what asthma medications you’re using.

Q. Should asthmatics be careful about taking aspirin?

A. Yes. Aspirin can trigger an attack in approximately twenty percent of asthmatics, particularly those who have nasal polyps.

Q. I have heard that, as an asthmatic, it isn’t safe for me to take a non-prescription cough medicine. Is this true?

A. In most cases, over-the-counter cough medicines are safe. Be aware, though, that a chronic or heavy cough may also indicate poorly controlled asthma. Consult your doctor before taking any non-prescription cough medicines.

Q. Are any risks associated with chicken pox and taking corticosteroids?

A. Evidence published by the American College of Allergy and Immunology concludes that children taking corticosteroids, by mouth or injection, are at greater risk of developing complications from chicken pox. This does not hold true for children using inhaled corticosteroids.

Q. Can taking beta blockers cause problems for asthmatics?

A. Yes. Beta blockers interfere with the action of epinephrine on the sympathetic nervous system to reduce the symptoms associated with high blood pressure, arrhythmia, angina, anxiety, migraines and other disorders. Most asthma medications stimulate the sympathetic nervous system and therefore have a conflicting effect. Ipratropium drugs, however, stimulate the parasympathetic nervous system and do not conflict with the action of beta blockers.

Using Inhalers and Nebulizers to Treat Asthma Attacks

Albuterol: Instant Relief for Asthmatics

The albuterol inhaler has revolutionized asthma treatment. The albuterol inhaler (often referred to as a metered dose inhaler or simply MDI) has revolutionized asthma treatment. The other good news is that in the vast majority of cases, an inhaler is all that’s required of both child and adult asthma sufferers to control their condition.

Albuterol is an inhaled bronchodilator that relaxes the muscles in the respiratory tract and dilates the airways to improve breathing. The albuterol might be mixed with cromolyn to prevent the onset of another attack. Prescribed usage might be one or two sprays every four to six hours, for example, depending on the severity of the condition and the attacks. Some patients with very mild asthma only need to inhale medication now and then, just when they feel they need it.

How to use your inhaler for maximum effect

  1. Shake the canister thoroughly to ensure even dispersal of the drug in the propellant.
  2. Hold the canister upright. This is important! If you don’t do this properly, the internal metering chamber won’t fill the next dose
    correctly.
  3. Hold the inhaler 1-2 inches away from your open mouth.
  4. Activate the inhaler.
  5. Breathe in steadily and slowly.
  6. Continue to inhale fully after the spray of asthma medicine has been delivered.
  7. Hold your breath for a count of 5-10 seconds.
  8. If you need two sprays do not deliver both during the same inhalation.

Albuterol Inhaler vs. Oral Medications

Corticosteroids

The function of corticosteroids is to reduce inflammation in the bronchi. Corticosteroids are identical to (or simulate the actions of) natural steroid hormones. These synthetic steroids are generally far more powerful than the natural hormones hydrocortisone and corticosterone.

Examples of corticosteroids include methylprednisolone, prednisolone, beclomethasone and triamcinolone.

Compared with taking medicine for the condition by mouth, the albuterol inhaler wins hands down!

The reason? When swallowing tablets or syrup, the drugs must pass through the stomach into the small intestine. This can take up to an hour. The drugs must then be absorbed into the blood vessels and carried (in diluted form) to the lungs. The albuterol inhaler short-circuits this drawn out process. It goes directly to its target: the lungs.

Nebulizers: How They Differ from Inhalers

Cromolyn

Cromolyn, an anti-inflammatory asthma medicine, is used routinely to prevent the onset of an asthma attack. Its function is to prevent the airways from swelling up when they come into contact with an asthma trigger. The drug, however, becomes ineffective once the attack is under way. Cromolyn is used in both MDIs and in liquid form in nebulizers. The drug is often used for the specific treatment of exercise induced asthma.

A nebulizer is a device that converts liquid asthma medicine into a cloud of tiny aerosol particles. The device is driven by a compressed air machine. It comprises a cup, a mouthpiece (usually attached to a mask) and thin plastic tubing that connects the mouthpiece to the compressed air machine.

Nebulizers have one big advantage over ordinary inhalers: they can deliver the drugs to the airways and control an asthma attack, even when movement of breath in and out of the lungs is severely reduced.

Used extensively in hospitals, nebulizers are particularly effective for the treatment of three categories of patients:

  • Infants and children under five years old
  • Adults and children who, for whatever reason, are unable to use a normal albuterol inhaler
  • Any age group suffering from a severe attack.